1. Field of the Invention
The subject of the present invention is medical appliances for functional dento-facial orthopaedic treatment and periodontics, aimed at correcting functional disorders with neurovegetative functions, more particularly functional disorders with:
nasal breathing, PA1 mastication, PA1 swallowing, PA1 phonation, PA1 in some instances it has been found, during treatment, that an incisor infraclusion (or gap) appears. In other words, a space in the vertical direction appears between the upper and lower incisors. This infraclusion is due, in particular, to the position of the tongue, this position being associated with atypical swallowing of a childlike type (inserting the tongue) between the incisors at the time of swallowing; PA1 in other instances, the transverse expansion that is sought and needed for fitting in all the teeth is not achieved; PA1 in the case of the treatment of certain adults, certain anomalies in the shape of the buccal osseous bases could not be corrected, such as: PA1 (a) that part of the tray that is intended to receive the lower incisors is in the shape of a straight channel which opens, at its two ends, into two tooth channels respectively, these being intended to receive respectively a lower canine, two lower premolars (corresponding to two milk-tooth molars of a child) and, possibly, at least one lower molar; PA1 (b) the length of the straight channel is designed to be long enough for the four lower incisors to have enough space to fit in it; PA1 (c) the depth of the straight channel is designed to completely enclose the lower incisors and, for this purpose, the height of the lingual and vestibular side walls delimiting the straight channel from the thick horizontal partition is at least equal to the height of the incisors up to their neck. PA1 the term "lingual (side) wall" or "lingual strip" or "lingual roll" denotes that part of the corrective appliances which runs alongside the lower teeth on the tongue side, in the region of the incisors, as well as the canine, the premolars (or milk-tooth premolars in the case of a child) and the molars; PA1 the term "palatine (side) wall" or "palatine strip" denotes the internal wall of the corrective appliances on the upper teeth and palate side; PA1 the term "vestibular (side) wall" or "vestibular strip" denotes the outer wall of the corrective appliances located on the lower and upper teeth side; PA1 the word "flexible", used to qualify the corrective appliances according to the invention, means that these appliances have an elastic behaviour when worn in the mouth and during chewing exercises performed in the course of treatment. Because of this elastic behaviour, the corrective appliances according to the invention have a toning effect and stimulate the facial and buccal muscles in the course of chewing exercises. PA1 the quantified values given to the thickness of the vestibular, lingual and palatine side walls, quoted in what follows of the description, are measured slightly mid-way up these walls. PA1 in the case of a patient who has his deciduous lower incisors, that is to say between about the age of 3 and up to about the age of 6 or above, the length of this channel is of the order of 20 mm.+-.2 mm; PA1 in the case of a patient who has lost his deciduous lower incisors and has not yet got his permanent lower incisors, the length of this channel is of the order of 22 mm.+-.2 mm; PA1 in the case of a patient who has got his permanent lower incisors, that is to say generally from about the age of 6 or above, the length of this channel is of the order of 24 mm.+-.1 mm. PA1 the upper maxillar arch to be surrounded as far as the boundary between the gum and the inner lip, without resting on the mucosa so as not to injure them; PA1 slight pressure to be exerted on the palate. PA1 the length and depth of the tooth channels receiving the canines, the premolars and, possibly, at least one molar; PA1 the thicknesses of the vestibular, lingual and palatine walls, these thicknesses advantageously being at least equal to 2 mm; the greatest thicknesses are reached by the lingual and palatine walls with corrective appliances that are aimed at transversely expanding the jaw bones; PA1 the thickness of the horizontal partition, which is preferably greater in the region of the incisors than the thickness of this same horizontal partition in the region of the other teeth, this being with a view to enjoying a greater toning effect at this point and thus increasing the pressures and therefore stimulations given to the incisors. In the region of the PA1 in the case of a patient who has his deciduous lower incisors, that is to say between about the age of 3 and up to about the age of 6 or above, the length of this channel is of the order of 20 mm.+-.2 mm; PA1 in the case of a patient who has lost his deciduous lower incisors and has not yet got his permanent lower incisors, the length of this channel is of the order of 22 mm.+-.2 mm; PA1 in the case of a patient who has got his permanent lower incisors, that is to say generally from about the age of 6 or above, the length of this channel is of the order of 24 mm.+-.1 mm. PA1 the upper maxillar arch to be surrounded as far as the boundary between the gum and the inner lip, without resting on the mucosa so as not to injure them; PA1 slight pressure to be exerted on the palate. PA1 the length and depth of the tooth channels receiving the canines, the premolars and, possibly, at least one molar; PA1 the thicknesses of the vestibular, lingual and palatine walls, these thicknesses advantageously being at least equal to 2 mm; the greatest thicknesses are reached by the lingual and palatine walls with corrective appliances that are aimed at transversely expanding the jaw bones; PA1 the thickness of the horizontal partition, which is preferably greater in the region of the incisors than the thickness of this same horizontal partition in the region of the other teeth, this being with a view to enjoying a greater toning effect at this point and thus increasing the pressures and therefore stimulations given to the incisors. In the region of the incisors, the thickness of the horizontal partition is preferably between 2 and 5 mm; PA1 in general, the external dimensions of the corrective appliances. PA1 tall enough to cover the teeth and the alveolar bone in part without reaching the frenum of the tongue; PA1 thick enough to allow, in certain instances, the transverse expansion needed to provide space for all the teeth.
and consequently aimed at correcting anomalies in the shape of the mouth, that is to say anomalies in the shape of the buccal osseous bases and malpositions of the teeth.
2. Background of the Related Art
In order to correct the position of the teeth in patients, it is known practice to employ corrective medical appliances known as "orthodontic positioners", which in plan view adopt the shape of the U and comprise at least one upper or lower trough but normally both an upper and a lower trough, each trough containing a number of depressions for receiving and retaining the teeth held therein and returning them to a position that is estimated as being the ideal position. There are various kinds of orthodontic positioner, what they have in common being that they have specific locations for the existing teeth and, in some cases, for the permanent teeth yet to come (see, for example, French Patent No. 2329247): movements of the teeth within these orthodontic positioners are therefore not permitted.
Devices known by the name of "channel activators" for treatment as part of dento-facial therapy are also known, from French Patent No. 2641964.
These channel activators consist, in general, of a double tray (or double trough) of semi-elliptical shape, the channels or troughs being separated by a horizontal partition (or thickness). Unlike in the aforementioned orthodontic positioners, there are no precise receivings for the teeth within the double channel. Indeed, the interior surface of the vertical or inclined walls of the double channel, among which the vestibular strip (external) and the lingual strip (internal), and the surface of the horizontal partition, are smooth.
The basic idea underlying the channel activators described in French Patent No. 2641964 is as follows: buccal deformation and the accompanying malpositions of the teeth are due to functional disorders with the neurovegetative functions that are: nasal breathing, mastication, swallowing and phonation. In most cases treated, the wearing of the tray activators and the exercises that accompany their day-to-day wearing allow the four aforementioned neurovegetative functions to be corrected and as a consequence allow the anomalies in the shape of the buccal osseous bases and malpositions of the teeth to be corrected.
However, the channel activators described in French Patent No. 2641964 are not entirely satisfactory as they actually present the following drawbacks:
a significant MDM (Maxillo-Dental Malocclusion) corresponding to teeth which are too large compared with the size of the jaw bones [(i.e. the upper jaw (maxilla) and the lower jaw (mandible)]; PA2 an hereditary class-III anomaly (or prognathism) corresponding to a forward position of the mandible, often associated with underdevelopment of the upper jaw bone.
An essential objective of the invention is therefore to provide a solution to the aforementioned drawbacks of the channel activators described in French Patent No. 2641964. Another important objective of the invention is to provide new corrective appliances for functional dento-facial orthopaedic treatments which are suitable for and effective in treating children who have their deciduous or permanent incisors, as well as adolescents and adults, in whom the risks of a relapse or of the appearance of further malpositions of the teeth in normal use of these appliances are minimized.